Display friendly tail-wagging when greeting an unfamiliar male dog
when not on a leash?

Always

Sometimes

Never

Don't know

Display friendly tail-wagging when greeting an unfamiliar female dog when not on a leash?

Always

Sometimes

Never

Don't know

Ignore or is aloof to an approaching unfamiliar male dog (when on leash?

Always

Sometimes

Never

Don't know

Ignore or is aloof to an approaching unfamiliar female dog (when on leash?

Always

Sometimes

Never

Don't know

Growls, lunges and/or gares teeth when approached on leash by an unfamiliar dog?

Always

Sometimes

Never

Don't know

Growls, lunges and/or gares teeth when approached off leash by an unfamiliar dog?

Always

Sometimes

Never

Don't know

I, the undersigned owner or owner's agent of the dog identified above, certify that I am over eighteen years of age and hereby consent to the participation of my dog in Fresh Air Training, L.L.C.'s dog training. (Please notify Wendy A. van Kerkhove if you are under eighteen years of age.)

I am aware and understand that there is always a risk involved when working with animals and that the training presents a risk of injury to all persons and animals in attendance, including myself, my dog, and any of my guests. I am aware and understand that dogs may be difficult to control and that not all dogs will be under control at all times and may cause injury, even when handled with the greatest amount of care. I am aware and understand that I will be exposing myself and my dog to other dogs that may cause injury and, conversely, that I will be exposing other persons and dogs to my dog, who may cause injury.

I have had full opportunity to discus all concerns I have about the forgoing risks with such parties as I deem appropriate. I have also made all inquiries and investigations related to such risks as I deem necessary, including specifically, but not limited to, an examination of potential training areas. I hereby accept and assume, without reservation, all risks associated with my (and my dog's) participation in the training, including specifically, but not limited to: the risk of any and all injuries to myself, my dog and any of my guests who may attend, whether or not related to the training or the nature and condition of the training area; the risk that my dog may cause injury to other persons and/or dogs attending the training; the risk that saliva, water, food and/or other debris may be present in the training area; and the risk of my noncompliance with any laws or regulations relative to my dog and its participation in the training (such as off-leash recreation area permit requirements, if any).

I hereby voluntarily waive any and all claims, demands, or actions, including any and all costs and expenses, related to or arising out of, directly or indirectly, my (and my dog's) participation in the training now and/or in the future, including specifically, but not limited to, any and all claims, demands, or actions against Fresh Air Training, L.L.C., the owner, manager, lessor, operator and/or lessee/tenant (whether primary or sub) of the premises where/within which the training area is located, or their respective members, shareholders, owners, partners, governors, directors, managers, officers, employees, agents, representatives, affiliates, successors and assigns (collectively, the Released Parties), related to any injuries or damages which I or my dog may suffer while attending any training session or which are alleged to have been caused by me or my dog.

I hereby voluntarily agree to indemnify and hold harmless the Released Parties from and against any claims, demands, or actions, including any and all costs and expenses, related to any injuries or damages which are alleged to have been caused by me or my dog.

I hereby certify that none of the Released Parties has made any representations, warranties, guarantees, or implied or expressed promises related to the training, the training area, the behavior of my dog, or this Informed Consent and Release.

I hereby certify that my dog has never bitten a human being and I am not aware of my dog's propensity to do so. (Please notify Wendy A. van Kerkhove if you are unable to make this representation.) Additionally, I represent and warrant that my dog will be up to date on all vaccinations each time I attend a Pint Sized Play session at any location. These vaccinations include rabies and DHPP (Distemper, Hepatitis, Parvo, Para-influenza). *